Thyroid dz Flashcards
when would you use thyroid scan and uptake?
hyperthyroidism
what is normal thyroid uptake at 4-6 hours?
5-15%
what is the normal thyroid uptake at 24 hours?
15-25%
what does the scan help you determine?
hetero or homogenous distribution
-determined by cold/hot areas of uptake on scan
what supplements can influence synthroid levels?
calcium and iron
what is a common side effect of synthroid?
CP
palpitations
what comorbidities can impact synthroid absorption?
malabsorption
GI conditions
what should you do when giving synthroid to an elderly person?
1/2 of a 25 mcg tablet twice a day
go slowly and make small dose changes
(risk of precipitating a cardiac event)
how often should you check TSH and free T4 levels?
every 6 weeks
what is armour thyroid?
pork thyroid extract
measured in grains
what is thyrotoxicosis?
hyperthyroidism
what is the dosing frequency of methimazole?
once daily
what is a significant side effect of antithyroid drugs?
agranulocytosis
which anti thyroid is the DOC during pregnancy?
PTU
which antithyroid drug inhibits conversion of T4-T3?
PTU (also has risk of hepatic failure)
which is the DOC during a thyroid storm?
PTU
what drug might you also consider if sxs don’t resolve quickly?
beta-blocker
(one month taper is common)
-reduces some peripheral conversion of T4-T3
what condition can worsen with RAI especially in smokers?
opthalmopathy
what has to happen before giving RAI?
stop antithyroid drugs for 7 dys before RAI
what is a typical presentation in the elderly of hyperthyroidism?
apathetic
AMS
what are the risk factors for thyroid nodules?
age female > male hx of head and neck irradiation family hx of thyroid cancer iodine deficiency
what factors increase the risk of malignancy?
pt 70 male > female hx of radiation family hx of thyroid cancer environmental toxins
when is a fine needle aspiration indicated?
palpable nodules and >10mm or with risk factors for malignancy
which type of thyroid nodule is the most common and has the best cure rate?
papillary
what type of thyroid nodule has the worst prognosis?
anaplastic (no differentiation)
which type of thyroid tumor is associated with MEN (multiple endocrine neoplasias)
medullary carcinoma
which alpha blockers are used during pheo surgery?
phenoxybenzamine
doxazosin
which calcium channel blockers are used during pheo surgery and other HTN crisis?
nifedipine ER
nicardipine ER
which beta blockers are used to manage tachycardia and arrhythmias during pheo surgery?
metoprolol
